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Menstruation, pregnancy and menopause spell trouble for teeth

With all the changes taking place in a woman's body during stages like puberty, pregnancy, lactation, menstruation, and menopause, women can expect some oral health changes as well. Elevated levels in sex hormones can also jump start oral health problems. Early on, menstruation may cause swollen gums, herpes-type lesions and ulcers. Later in life, women going through menopause may experience oral problems like pain, burning sensation, bad taste, and dry mouth, as well as bone loss due to osteoporosis, a condition characterized by a decrease in bone mass with decreased density and enlargement of bone spaces. Pregnant women frequently experience increased oral sensitivity and often suffer inflammation of the gums, or gingivitis, due to hormonal changes. Along with a strict oral hygiene routine, the patient should begin a personal and professional plaque control regimen to treat or prevent gingivitis. Periodontal therapy, if necessary, should begin after the woman gives birth. When the dentist asks a woman whether she has recently given birth, might possibly be pregnant, is breast feeding, or is going through menopause, the dentist isn't just nosy. This information is crucial to a dentist planning to administer medication because if a woman is pregnant or lactating, the medication could affect the fetus or newborn child.
Over the last 20 years, researchers have found an increasing connection between oral health and systemic diseases such as diabetes, heart disease and stroke. Now, research is pointing in another direction: osteoporosis increases the risk factors for tooth loss and periodontal disease. Studies are beginning to show a connection between osteoporosis and periodontal disease and that drugs in the testing stages may help prevent tooth loss. What this means to consumers is that in the near future, dentists may be able to detect osteoporosis through x-rays taken right in the office during a routine check-up. These x-rays have the ability to show the amount of bone loss from year to year, signifying advancing stages of the disease. Dentists will be able to detect some of the early warning signs of osteoporosis by noting advancing gum disease, dentures becoming loose, or ill-fitting dentures that lead to mouth sores and loss of oral function (speaking or eating). Researchers hope that bone loss and its connection to periodontal disease and tooth loss will be treatable with either the use of anti-inflammatory drugs or a mouth rinse. The study also reports that to lower the chances for bone loss, topical solutions may also become available.

Women's oral health depends on their different stages of life. For many women, these changes are directly related to surges in sex hormone levels, such as in puberty, menstruation, pregnancy, lactation and menopause. Women are also more likely to be diagnosed with TMJ, Myofacial pain, eating disorders, and Sjogren's Syndrome (dry mouth).
 

What types of conditions will my dentist watch for?

As a woman, you need to adhere to good oral hygiene. Make sure to brush with fluoride toothpaste at least twice a day and after each meal when possible and floss thoroughly each day. To help avoid problems, your dentist may request to see you more frequently during hormonal surges.


Puberty

The surge in hormones that occurs during puberty may cause swollen gums, especially during menstruation. Herpes-type lesions and ulcers also can develop. Girls may experience sensitive gums that react more to irritants.


Oral Contraceptives

Oral contraceptives mimic pregnancy because they contain progesterone or estrogen. Therefore gingivitis may occur with long-term use. Use of certain antibiotics while taking oral contraceptives can decrease its effectiveness. Women who use birth control pills are twice as likely to develop dry sockets and should consult their dentist before scheduling major dental procedures.

Pregnancy
Pregnant women have a risk for increased inflammation of the gums because of the surge in estrogen and progesterone. If the plaque isn't removed, it can cause gingivitis-red, swollen, tender gums that are more likely to bleed. And, women with periodontal disease may be at risk for pre-term, low-birth weight babies. They are also at risk for developing pregnancy tumors- inflammatory, benign growths that develop when swollen gums become irritated. Usually these tumors shrink soon after the pregnancy is over. If a women experiences morning sickness, it is important to neutralize the acid caused by vomiting which causes tooth erosion. Patients can use a paste made of baking soda and water, rubbing it on the teeth. After 30 seconds, rinse off the paste, then brush and floss. If this is not possible, rinse with water.


Menopause

During menopause, some women can experience dry mouth, burning sensation, and changes in taste. Gums can even become sore and sensitive. Hormonal replacement therapy may cause gums to bleed, swell and become red.


Other factors

Diet pills and certain medications (over-the-counter and prescriptions) can decrease salivary flow, which puts patients at risk for cavities, gum disease and discomfort. Patients with eating disorders, such as bulimia (self-induced vomiting) can't hide their symptoms from their dentists because the episodes of binging and purging cause erosion on the backside of the upper front teeth. (An additional sign is sores that appear at the corners of the mouth.) Smoking also creates a higher risk for periodontal disease.

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